TechniqueTips

Technique Tips A New Look at Repairing Fractured

Metal-Ceramic Restorations: Use of a Universal Bonding System
and Resin Composite, following Sandblasting
The fracture of the ceramic from a metal-
ceramic restoration may often lead to
an emergency attendance, as previously
explained.1 It is the aim of this technique
tip to describe a contemporary method of
repairing fractured metal-ceramic restorations
using only the Cojet sand included in the
Cojet system (3M ESPE) but not the other
components. Cojet sand contains 30 micron
aluminium oxide particles modified with silicic
acid: the metal surface is sandblasted with this
at a pressure of 0.25 MPa at a distance of 1 cm,
causing the surface to become impregnated
with silica. This facilitates a bond to resin
composite using a silane. In the illustrated case
report, the facing debonded from the bridge
pontic. The defective bridge was isolated with
rubber dam, the patient was provided with
a nosepiece and protective eyewear. After Figure 1. Fractured pontic isolated and sandblasted using Cojet sand.
sandblasting the exposed metal surface with
Cojet Sand (Figure 1), a Universal adhesive
Patients with fractured metal-ceramic crowns
(Scotchbond Universal: 3M) containing both
and bridges should therefore be appraised
a silane and the resin 10-MDP (originally a
of the paucity of evidence, but should be
constituent of the Panavia series of resin-luting
offered a repair when in possession of such
agents which have a demonstrable bond
information. It is, however, the authors
to metal2,3) was applied and light cured. An
experience that the patients will generally
alternative bonding agent could be Clearfil
opt for a repair as a minimal intervention (and
Universal (Kuraray), as it also contains 10-MDP
cheaper!) option, even if no evidence-based
and a silane. Whereas the full Cojet kit contains
guarantee can be given.
a resin-based opaquer, an alternative may be a
dentine shade of resin composite. Accordingly,
after application and curing of the bonding References
agent, a dentine shade was applied in order 1. Burke FJT. Technique Tips Repairing
to mask the metal and the repair was then fractured metal-ceramic restorations
completed using an enamel shade of resin using tribochemical impregnation. Dent
composite (Filtek Supreme XTE: 3M) (Figure 2). Update 2016; 43: 989.
In conclusion, while the technique 2. Aboush YEY, Jenkins CBG. Tensile strength
used in this case is based on the ability of the of enamel-resin metal. J Prosthet Dent
Cojet sand to impregnate the metal surface 1989; 61: 688694.
with a layer of silica and upon a knowledge of 3. Fonseca RG, de Almeida JG, Haneda
how the various components of the suggested IG, Adabo GL. Effect of metal primers Figure 2. Pontic repaired using a layer of
opaque (dentine shade) composite followed
bonding agents might behave, there are no on bond strength of resin cements to
by an enamel shade, following application of a
long-term clinical evaluations to demonstrate base metals. J Prosthet Dent 2009; 101:
Universal adhesive.
the long-term effectiveness of the technique. 262268.

FJT Burke, DDS, MSc, MDS, MGDS, FDS(RCS Edin), FDS RCS(Eng), FFGDP(UK), FADM, Primary Dental Care Research Group, University of
Birmingham School of Dentistry, 5 Mill Pool Way, Pebble Mill, Birmingham B5 7EG, UK.

January 2017 DentalUpdate 81